Mind Revival Psych Inc
NPI 1043182280 · Psychiatric/Mental Health Nurse Practitioner · Chicago, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mind Revival Psych Inc is a Psychiatric/Mental Health Nurse Practitioner organization in Chicago, IL (NPI 1043182280).
Provider details
- NPI number
- 1043182280
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Ebonie Williams, Np/Owner(708) 715-2035
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 1918 W Irving Park RdChicago, IL 60613-6267Phone: (773) 690-5300Fax: (870) 201-4835
Registry dates
- Enumerated
- 2025-09-18
- Last updated
- 2025-12-12
- Certified
- 2025-12-12
Frequently asked questions
- What is Mind Revival Psych Inc's NPI number?
- Mind Revival Psych Inc's National Provider Identifier (NPI) is 1043182280, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mind Revival Psych Inc?
- Mind Revival Psych Inc is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Mind Revival Psych Inc located?
- Mind Revival Psych Inc's practice location on file with NPPES is 7201 S Stony Island Ave # 7, Chicago, IL 60649-2806.
- What is Mind Revival Psych Inc's phone number?
- The practice phone number listed in the NPPES registry for Mind Revival Psych Inc is (773) 690-5300.
- Does Mind Revival Psych Inc accept Medicare?
- Mind Revival Psych Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mind Revival Psych Inc?
- The authorized official listed on Mind Revival Psych Inc's NPPES record is Ebonie Williams, Np/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mind Revival Psych Inc's NPI active?
- Yes — Mind Revival Psych Inc's NPI (1043182280) is active in the NPPES registry as of the last update on 2025-12-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.